Pulmozyme (dornase alfa inhalation solution) — Medica

Initial criteria

• Medication is prescribed by or in consultation with a pulmonologist or a physician who specializes in the treatment of cystic fibrosis

Reauthorization criteria

• Patient continues to have cystic fibrosis and the medication remains prescribed by or in consultation with a pulmonologist or a physician who specializes in cystic fibrosis

Approval duration

1 year